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非酒精性脂肪性肝炎(NASH)背景下的肝细胞癌:发病机制的最新进展。

Hepatocellular carcinoma in the context of non-alcoholic steatohepatitis (NASH): recent advances in the pathogenic mechanisms.

机构信息

Service d'Hépato-Gastro-Entérologie, AP-HP, F-75012 Paris, France.

Centre de Recherche Saint-Antoine, INSERM, Sorbonne Université, F-75012 Paris, France.

出版信息

Horm Mol Biol Clin Investig. 2020 Feb 29;41(1):/j/hmbci.2020.41.issue-1/hmbci-2019-0044/hmbci-2019-0044.xml. doi: 10.1515/hmbci-2019-0044.

Abstract

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. HCC is particularly aggressive and is one of the leading causes of cancer mortality. In recent decades, the epidemiological landscape of HCC has undergone significant changes. While chronic viral hepatitis and excessive alcohol consumption have long been identified as the main risk factors for HCC, non-alcoholic steatohepatitis (NASH), paralleling the worldwide epidemic of obesity and type 2 diabetes, has become a growing cause of HCC in the US and Europe. Here, we review the recent advances in epidemiological, genetic, epigenetic and pathogenic mechanisms as well as experimental mouse models that have improved the understanding of NASH progression toward HCC. We also discuss the clinical management of patients with NASH-related HCC and possible therapeutic approaches.

摘要

肝细胞癌(HCC)是最常见的肝癌类型。HCC 特别具有侵袭性,是癌症死亡的主要原因之一。近几十年来,HCC 的流行病学状况发生了重大变化。虽然慢性病毒性肝炎和过量饮酒长期以来一直被认为是 HCC 的主要危险因素,但非酒精性脂肪性肝炎(NASH)与肥胖和 2 型糖尿病在全球的流行并行不悖,已成为美国和欧洲 HCC 日益增多的原因。在这里,我们回顾了近年来在流行病学、遗传学、表观遗传学和发病机制以及实验小鼠模型方面的进展,这些进展提高了对 NASH 向 HCC 进展的理解。我们还讨论了 NASH 相关 HCC 患者的临床管理和可能的治疗方法。

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